Mast cell mediated inflammatory conditions, in particular asthma, are a growing public health concern. Asthma is frequently characterized by progressive development of hyper-responsiveness of the trachea and bronchi to both immunospecific allergens and generalized chemical or physical stimuli, which lead to the onset of chronic inflammation. Leukocytes containing IgE receptors, notably mast cells and basophils, are present in the epithelium and underlying smooth muscle tissues of bronchi. These leukocytes initially become activated by the binding of specific inhaled antigens to the IgE receptors and then release a number of chemical mediators. For example, degranulation of mast cells leads to the release of proteoglycans, peroxidase, arylsulfatase B, chymase, and tryptase, which results in bronchiole constriction.
Tryptase is stored in the mast cell secretory granules and is the major protease of human mast cells. Tryptase has been implicated in a variety of biological processes, including degradation of vasodilatory and bronchodilatory neuropeptides (Caughey, et al., J. Pharmacol. Exp. Ther., 1988, 244, pages 133-137; Franconi, et al., J. Pharmacol. Exp. Ther., 1988, 248, pages 947-951; and Tam, et al., Am. J. Respir. Cell Mol. Biol., 1990, 3, pages 27-32) and modulation of bronchial responsiveness to histamine (Sekizawa, et al., J. Clin. Invest., 1989, 83, pages 175-179).
As a result, tryptase inhibitors may be useful as anti-inflammatory agents (K Rice, P. A. Sprengler, Current Opinion in Drug Discovery and Development, 1999, 2(5), pages 463-474) particularly in the treatment of chronic asthma (M. Q. Zhang, H. Timmerman, Mediators Inflamm., 1997, 112, pages 311-317), and may also be useful in treating or preventing allergic rhinitis (S. J. Wilson et al, Clin. Exp. Allergy, 1998, 28, pages 220-227), inflammatory bowel disease (S. C. Bischoff et al, Histopathology, 1996, 28, pages 1-13), psoriasis (A. Naukkarinen et al, Arch. Dermatol. Res., 1993, 285, pages 341-346), conjunctivitis (A. A. Irani et al, J. Allergy Clin. Immunol., 1990, 86, pages 34-40), atopic dermatitis (A. Jarvikallio et al, Br. J. Dermatol., 1997, 136, pages 871-877), rheumatoid arthritis (L. C. Tetlow et al, Ann. Rheum. Dis., 1998, 54, pages 549-555), osteoarthritis (M. G. Buckley et al, J. Pathol., 1998, 186, pages 67-74), gouty arthritis, rheumatoid spondylitis, and diseases of joint cartilage destruction.
In addition, tryptase has been shown to be a potent mitogen for fibroblasts, suggesting its involvement in the pulmonary fibrosis in asthma and interstitial lung diseases (Ruoss et al., J. Clin. Invest., 1991, 88, pages 493-499).
Therefore, tryptase inhibitors may be useful in treating or preventing fibrotic conditions (J. A. Cairns and A. F. Walls, J. Clin. Invest., 1997, 99, pages 1313-1321) for example, fibrosis, scleroderma, pulmonary fibrosis, liver cirrhosis, myocardial fibrosis, neurofibromas and hypertrophic scars.
Additionally, tryptase inhibitors may be useful in treating or preventing myocardial infarction, stroke, angina and other consequences of atherosclerotic plaque rupture (M. Jeziorska et al, J. Pathol., 1997, 182, pages 115-122).
Tryptase has also been discovered to activate prostromelysin that in turn activates collagenase, thereby initiating the destruction of cartilage and periodontal connective tissue, respectively.
Therefore, tryptase inhibitors could be useful in the treatment or prevention of arthritis, periodontal disease, diabetic retinopathy, and tumour growth (W. J. Beil et al, Exp. Hematol., (1998) 26, pages 158-169). Also, tryptase inhibitors may be useful in the treatment of anaphylaxis (L. B. Schwarz et al, J. Clin. Invest., 1995, 96, pages 2702-2710), multiple sclerosis (M. Steinhoff et al, Nat. Med. (N. Y.), 2000, 6(2), pages 151-158), peptic ulcers and syncytial viral infections.
Substituted arylmethylamines, represented as by a compound of formula (A), their preparation,
pharmaceutical compositions containing these compounds, and their pharmaceutical use in the treatment of disease states capable of being modulated by the inhibition of tryptase are reported in U.S. Pat. No. 6,977,263. Specifically disclosed in U.S. Pat. No. 6,977,263, are compounds of the following formulae
U.S. Pat. No. 6,977,263, however, does not disclose any of the aforesaid [(aminomethyl-phenyl)-piperidin-1-yl]-[indolyl]-methanone species wherein the position para to the aminomethyl group on the phenyl moiety thereof is also substituted with a fluoro group. Furthermore, U.S. Pat. No. 6,977,263, only discloses one [(aminomethyl-phenyl)-piperidin-1-yl]-[indolyl]-methanone compound wherein an aromatic carbon in the indole moiety thereof, other than the one bonded to the carbonyl, is substituted; more specifically solely wherein the 5-position of the indole is substituted by methoxy.
Bioorg. Med. Chem. Lett. 15, 2734 (2005) discloses three types of [(aminomethyl-phenyl)-piperidin-1-yl]-[1H-indoly-3-yl]-methanones as tryptase inhibitors. One type of the inhibitors is directed to a compound of formula B wherein none of the aromatic carbons in the indole moiety
thereof, other than the one bonded to the carbonyl, is substituted, whereas the indole nitrogen is substituted by R1 as hydrogen, methyl, ethyl, isopropyl, propyl, isobutyl, butyl, hexyl, 2-methoxyethyl, cyclohexylmethyl, cyclopropylmethyl, 3-pyridyl, 2-thiazole, acetyl, thiophene-2-carbonyl, benzenesulfonyl, or methanesulfonyl. The second type of the inhibitors is directed to a compound of formula C wherein the indole nitrogen is substituted only by hydrogen and a single aromatic
carbon in the indole moiety thereof, other than the one bonded to the carbonyl, is substituted by R as methyl in the 4-, 5-, 6-, or 7-position, or fluoro in the 7-position. The third type of the inhibitors is directed to a compound of formula D wherein a single aromatic carbon in the indole moiety thereof,
other than the one bonded to the carbonyl, is substituted by methyl in the 7-position, and the indole nitrogen is substituted by R1 as methyl, ethyl, propyl, butyl, or 2-methoxyethyl. Bioorg. Med. Chem. Lett. 15, 2734 (2005) also discloses that substitution on an aromatic carbon in the indole in the 5- or 7-position were tolerated while substitution in the 4- or 6-position gave less active compounds.
No disclosure exists in U.S. Pat. No. 6,977,263 or Bioorg. Med. Chem. Lett. 15, 2734 (2005) of an indole containing tryptase inhibitors wherein: (1) the position para to the aminomethyl group on the phenyl moiety thereof is also substituted with a fluoro group; (2) the indole nitrogen is substituted by 2-methoxyethyl; or (3) two or more aromatic carbons in the indole moiety thereof, other than the one bonded to a carbonyl, are substituted, and that has particularly valuable pharmaceutical properties as a tryptase inhibitor. Such a compound should readily have utility in treating a patient suffering from conditions that can be ameliorated by the administration of an inhibitor of tryptase, e.g., mast cell mediated inflammatory conditions, inflammation, and diseases or disorders related to the degradation of vasodilatory and bronchodilatory neuropeptides, and have diminished liability for semicarbazide-sensitive amine oxidase (SSAO) metabolism.